MedWorm: Atrial Septal Defect

Dextrocardia, atrial septal defect, severe developmental delay, facial anomalies, and supernumerary ribs in a child with a complex unbalanced 8;22 translocation including partial 8p duplication

American Journal of Medical Genetics Part A — Thu, 02 Feb 2012 05:00:00 +0100

We report on a child with dextrocardia, atrial septal defect (ASD), severe developmental delay, hypotonia, 13 pairs of ribs, left preauricular choristoma, hirsutism, and craniofacial abnormalities. Prenatal cytogenetic evaluation showed karyotype 46,XY,?dup(8p)ish del(8)pter. Postnatal array CGH demonstrated a 6.8 Mb terminal deletion at 8p23.3–p23, an interstitial 31.1 Mb duplication within 8p23.1–p11, and a terminal duplication of 0.24 Mb at 22q13.33, refining the karyotype to 46,XY,der(8)dup(8)(p23.1p11.1)t(8;22)(p23.1;q13.1).ish der(8)dup(8)(p23.1p11.1)t(8;22)(p23.1;q13.1) (D8S504‐,MS607 + ,ARSA + ,D8Z1 + , RP115713 + +). Previous reports of distal 8p deletion, 8p duplication, and distal 22q duplication have shown similar manifestations, including congenital...

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Chromosome 4q deletion syndrome: Narrowing the cardiovascular critical region to 4q32.2–q34.3

American Journal of Medical Genetics Part A — Thu, 02 Feb 2012 05:00:00 +0100

Triblock copolymers of ε-caprolactone, trimethylene carbonate, and L-lactide: Effects of using random copolymer as hard-block.

Journal of the Mechanical Behavior of Biomedical Materials — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Widjaja LK, Kong JF, Chattopadhyay S, Lipik VT, Liow SS, Abadie MJ, Venkatraman SS Abstract A series of triblock copolymers comprising end block of PLLA modified with PCL, and random copolymer of PCL and PTMC as soft segment were synthesized. DSC data show that PCL disrupted the crystallinity of PLLA, making the hard block to be completely amorphous when the PCL content is 50%. Correspondingly, the addition of PCL into PLLA block enhances the elongation of the triblock considerably. With regards to the elasticity, however, creep test results show that adding PCL to PLLA block seems to reduce the "equilibrium" recovery, while cyclic test results shows that the instantaneous recovery increased significantly with more PCL inside PLLA block. It was also observed that the degra...

Traumatic bronchial rupture and platypnea-orthodeoxia.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:17:36 +0100

Authors: Odell JA, Keller CA, Erasmus DB, Stritt MT Abstract A patient with blunt trauma and traumatic bronchial rupture and lung collapse had prominent symptoms of platypnea-orthodeoxia syndrome. These symptoms were relieved by bronchial repair. The syndrome is rarely seen and is usually associated with a patent foramen ovale or atrial septal defect. The syndrome has not been described previously in association with traumatic bronchial rupture. PMID: 22269739 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Life-threatening isometric-exertion related cardiac perforation 5 years after amplatzer atrial septal defect closure: should isometric activity be limited in septal occluder holders?

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:16:56 +0100

Authors: Santini F, Morjan M, Onorati F, Morando G, Faggian G, Mazzucco A PMID: 22269743 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Iatrogenic atrial septal defect and aortoatrial fistula in a patient with endovascular prosthesis in the inferior vena cava.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:13:34 +0100

We report the case of a liver transplant patient with a stenosis in the anastomosis of the suprahepatic veins to inferior vena cava, treated by self-expanding prosthesis, who developed an aorto-right atrial fistula and an atrial septal defect. Open heart surgery was performed to correct the defects. Transthoracic echocardiogram 1 year later revealed no evidence of residual shunt. PMID: 22269763 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

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Voluminous atrial septal aneurysm may mask a large double atrial septal defect.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:12:43 +0100

Authors: Scaffa R, Spaziani C, Leporace M, Leonetti S, Di Roma M, Gaspardone A, De Paulis R PMID: 22269768 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

[Massive intravascular haemolysis after percutaneous atrial septal defect closure.]

Kardiologia Polska — Wed, 25 Jan 2012 06:54:02 +0100

We present a case of a 55 year-old female, who survived a complication of percutaneous closure of atrial septal defect never described before. Within the first day after treatment the device has dislodged and got stuck in the mitral valve apparatus. This has caused mitral insufficiency and massive haemolysis which resolved after interventional removal of the device. Kardiol Pol 2012; 70, 1: 58-59. PMID: 22267428 [PubMed - as supplied by publisher] (Source: Kardiologia Polska)

Severe hypoxaemia with a left ventricular assist device in a minipig model with an undiagnosed congenital cardiac disease

Laboratory Animals — Wed, 25 Jan 2012 05:00:00 +0100

In conclusion, if hypoxaemia presents after implementation of an LVAD, the presence of a right–left shunt must be ruled out. The first step must be a judicious reduction in assist device flow to minimize intracardiac shunting. Subsequently, atrial septal closure of the defect should be considered. We report an experimental model of severe hypoxaemia after placement of an LVAD as part of a larger research project. (Source: Laboratory Animals)

Iatrogenic Atrial Septal Defect and Aortoatrial Fistula in a Patient With Endovascular Prosthesis in the Inferior Vena Cava [CASE REPORTS]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

We report the case of a liver transplant patient with a stenosis in the anastomosis of the suprahepatic veins to inferior vena cava, treated by self-expanding prosthesis, who developed an aorto–right atrial fistula and an atrial septal defect. Open heart surgery was performed to correct the defects. Transthoracic echocardiogram 1 year later revealed no evidence of residual shunt. (Source: The Annals of Thoracic Surgery)

Voluminous Atrial Septal Aneurysm May Mask a Large Double Atrial Septal Defect [IMAGES IN CARDIOTHORACIC SURGERY]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

(Source: The Annals of Thoracic Surgery)

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Traumatic Bronchial Rupture and Platypnea-Orthodeoxia [CASE REPORTS]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

A patient with blunt trauma and traumatic bronchial rupture and lung collapse had prominent symptoms of platypnea-orthodeoxia syndrome. These symptoms were relieved by bronchial repair. The syndrome is rarely seen and is usually associated with a patent foramen ovale or atrial septal defect. The syndrome has not been described previously in association with traumatic bronchial rupture. (Source: The Annals of Thoracic Surgery)

Life-Threatening Isometric-Exertion Related Cardiac Perforation 5 Years After Amplatzer Atrial Septal Defect Closure: Should Isometric Activity Be Limited in Septal Occluder Holders? [IMAGES IN CARDIOTHORACIC SURGERY]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

(Source: The Annals of Thoracic Surgery)

Intra-operative device closure of multiple atrial septal defects facilitated by a unique atrial septum remodeling technique: initial results and experience in 11 patients [CONGENITAL]

European Journal of Cardio-Thoracic Surgery — Wed, 18 Jan 2012 05:00:00 +0100

CONCLUSIONS Atrial septum remodeling technique seems to be a safe and effective method that could largely facilitate the successful IODC of multiple ASDs. (Source: European Journal of Cardio-Thoracic Surgery)

What other anomalies? Failure to wean post ventricular septal defect repair secondary to anomalous origin of the left coronary artery from the pulmonary artery

Pediatric Anesthesia — Fri, 13 Jan 2012 12:08:52 +0100

SummaryA six week old infant underwent ventricular septal defect and atrial septal defect closure. Preoperative echocardiography showed evidence of pulmonary hypertension. The post operative course was complicated failure to wean from ventilatory and inotropic support. Echocardiography showed severe left ventricular (LV) dysfunction and suggested some fistulous drainage of the left coronary artery into the right pulmonary artery; this anomalous drainage of the left coronary artery into the right pulmonary artery (ALCAPA) was confirmed with coronary angiogram. Re‐implantation of the left coronary artery into the aorta was performed. Extra‐corporeal membrane oxygenation (ECMO) was required to allow time for ventricular recovery. Supports were weaned gradually, with concurrent evidence of...

Does the amplatzer septal occluder device alter ventricular contraction pattern? A ventricular motion analysis by MR tagging

Journal of Magnetic Resonance Imaging — Fri, 13 Jan 2012 05:00:00 +0100

Conclusion:The Amplatzer occluder itself does not change the ventricular contraction pattern. All volume and myocardial deformation changes were caused by ventricular loading shifts. J. Magn. Reson. Imaging 2012;. © 2012 Wiley Periodicals, Inc. (Source: Journal of Magnetic Resonance Imaging)

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CD44 expression in plexiform lesions of idiopathic pulmonary arterial hypertension

Pathology International — Tue, 10 Jan 2012 05:00:00 +0100

Plexiform lesions in pulmonary arteries are a characteristic histological feature for idiopathic pulmonary arterial hypertension (IPAH). The pathogenesis of the plexiform lesion is not fully understood, although it may be related to endothelial cell dysfunction and local inflammation. CD44 is a cell adhesion molecule and it is also involved in angiogenesis, endothelial cell proliferation and migration. The expression of CD44 was examined in lung plexiform lesions obtained from patients with IPAH (IPAH group, n= 7) and pulmonary arterial hypertension associated with atrial septal defect (ASD‐PAH group, n= 4). Expression of CD44 was detected in 49 out of 52 plexiform lesions (93%) from all patients in the IPAH group, whereas 31 plexiform lesions obtained from the ASD‐PAH group lacked CD4...

Transcatheter closure of atrial septal defect in a geriatric population

Catheterization and Cardiovascular Interventions — Tue, 10 Jan 2012 05:00:00 +0100

Conclusion: Transcatheter closure of ASD in geriatric patients can be performed safely. This procedure contributes to significant improvement of symptoms and positive cardiac remodeling. Long‐term follow‐up is mandatory, especially for patients with mitral regurgitation. © 2012 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

Classic and non-classic forms of mitral valve prolapse.

Anadolu Kardiyol Der... — Wed, 04 Jan 2012 05:00:00 +0100

CONCLUSION: The classic form of mitral valve prolapse is more tightly associated with morbid complications, and a more frequent follow-up control in this group of patients may be useful. PMID: 22214735 [PubMed - as supplied by publisher] (Source: Anadolu Kardiyol Der...)

Successful maternal-foetal outcome using nitric oxide and sildenafil in pulmonary hypertension with atrial septal defect and HIV infection.

Singapore Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

We describe successful maternal-foetal outcome for a 30-year-old woman who was found to have severe pulmonary hypertension, human immunodeficiency virus (HIV) and an atrial septal defect. Prior to delivery, she was managed with subcutaneous enoxaparine, sildenafil, nitric oxide, careful maintenance of a euvolemic status and antiretroviral therapy. She was planned for an elective Caesarean section to reduce the risk of maternal-foetal HIV transmission, but went into labour in the coronary care unit. During delivery, antibiotic prophylaxis was given, although there was insufficient time for intravenous zidovudine. Peripartum, the patient was continued on nitric oxide and subcutaneous enoxaparine. She was eventually weaned off the nitric oxide and recovered well. PMID: 22252195 [PubMed - ...

Graded balloon dilatation as a prerequisite to Amplatzer device closure of perforated interatrial septal aneurysm.

Singapore Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Goel PK, Kapoor A Abstract This case report describes a modification in the technique of atrial septal device closure in a patient with atrial septal defect (ASD) with associated atrial septum aneurysm and significant left-to-right shunt through multiple perforations. Graded balloon dilatation of the aneurysm was performed in this patient, as a preamble to successful deployment of a single large Amplatzer atrial septal occluder, closing the ASD completely and entrapping the aneurysm as a whole. PMID: 22252193 [PubMed - in process] (Source: Singapore Medical Journal)

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Cardiopulmonary bypass

Surgery (Medicine Publishing) — Fri, 23 Dec 2011 00:08:11 +0100

This article gives an insight into the acute and long-term complications of CPB; it also discusses the support devices allied with cardiac surgery, from intra-aortic balloon counterpulsation to the components of long-term extracorporeal membrane oxygenation. (Source: Surgery (Medicine Publishing))

Novel NKX2-5 mutations responsible for congenital heart disease.

Genetics and Molecular Research — Thu, 22 Dec 2011 03:54:02 +0100

Novel NKX2-5 mutations responsible for congenital heart disease. Genet Mol Res. 2011;10(4):2905-15 Authors: Wang J, Liu XY, Yang YQ Abstract Congenital heart disease (CHD) is the most common birth defect and is the leading cause of infant morbidity and mortality resulting from birth defects. Increasing evidence demonstrates that genetic variation in the NKX2-5 gene, which encodes a homeobox-containing transcription factor crucial to cardiogenesis, is an important molecular determinant for CHD. Nevertheless, the genetic components underlying CHD remain largely unknown. We screened NKX2-5 for potential molecular defects in patients with CHD. The entire coding region of NKX2-5 was initially sequenced in a cohort of 268 unrelated patients with CHD. The relatives of the patients...

Coronary Artery Disease in Adult Congenital Heart Disease: Outcome After Coronary Artery Bypass Grafting [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Wed, 21 Dec 2011 05:00:00 +0100

Conclusions Concomitant CABG may be required at the time of correction of ACHD. Survival is higher when a LIMA graft is used, and late functional outcome is good, with a low incidence of late angina and need for reintervention. (Source: The Annals of Thoracic Surgery)

Transcaval Correction of Partial Anomalous Pulmonary Venous Drainage Into the Superior Vena Cava [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

The Annals of Thoracic Surgery — Wed, 21 Dec 2011 05:00:00 +0100

Conclusions The vertical transcaval approach is a simple, highly reproducible technique for correction of partial anomalous pulmonary venous drainage into the SVC. It yields excellent results, with unobstructed pulmonary and systemic venous flow and without arrhythmia development. It can also be performed through a cosmetic right posterior thoracotomy. (Source: The Annals of Thoracic Surgery)

Long-term follow-up of iatrogenic atrial septal defect after percutaneous mitral balloon valvuloplasty.

Texas Heart Institute Journal — Mon, 19 Dec 2011 09:30:03 +0100

In this study, we evaluated the factors affecting the development of iatrogenic atrial septal defect and searched for the possible influence of this defect on long-term outcomes.We reviewed the medical records of 267 patients who had undergone successful percutaneous mitral balloon valvuloplasty for symptomatic moderate or severe mitral stenosis from January 2000 through March 2004. Sixty-three of the 267 patients were enrolled in a face-to-face follow-up study. We noted their clinical and demographic characteristics. All included patients were asked for the endpoints of repeat percutaneous mitral balloon valvuloplasty or mitral valve surgery, cerebrovascular accident or transient ischemic attack, and the need of intervention for the iatrogenic atrial septal defect. They underwent standard...

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Echocardiography based estimation of pulmonary vascular resistance in patients with pulmonary hypertension: a simultaneous Doppler echocardiography and cardiac catheterization study

European Journal of Echocardiography — Wed, 14 Dec 2011 05:00:00 +0100

Conclusion The proposed Doppler-derived formula for estimating PVR based on the conventionally used invasive equation strongly correlates with invasive gold standard measures. (Source: European Journal of Echocardiography)

Orthodontic treatment of a transposed gigantic canine --a case report [ClinicalSection]

Journal of Orthodontics — Fri, 09 Dec 2011 05:00:00 +0100

Cuspid gigantism or radicomegaly is a rare occurrence often associatedwith a hereditary, X-linked condition, called oculo-cardio-facio-dental (OFCD)syndrome. This syndrome is also characterized by atrial septal defects and/orventricular septal defects, congenital cataracts and unusual facial characteristics.Confirmation of this syndrome is often provided by dentists or orthodontistswhen they diagnose an extremely large canine root length from the panoramicradiograph. The following case report shows a multidisciplinary approach tothe dental treatment of a patient with OFCD syndrome and a canine-first premolartransposition. The orthodontic approach required a mini-plate to achieve significantmesial movement of a gigantic maxillary canine that erupted in close contactwith the first molar. (So...

Orthodontic treatment of a transposed gigantic canine --a case report [Clinical Section]

Journal of Orthodontics — Fri, 09 Dec 2011 05:00:00 +0100

Totally endoscopic atrial septal repair using no robotic techniques [ORIGINAL ARTICLE]

Asian Cardiovascular and Thoracic Annals — Wed, 07 Dec 2011 05:00:00 +0100

We describe a technique of totally endoscopic closed-chest atrial septal defect closure without the aid of a robotic device. Twenty patients underwent totally endoscopic atrial septal defect repair using no robotic techniques between May 2009 and December 2009. No major intraoperative or postoperative complications were observed. One operation was converted to a conventional sternotomy because bleeding from the aortic root could not be controlled. Closure of an atrial septal defect can be performed safely and effectively via an endoscopic approach using no robotic techniques. (Source: Asian Cardiovascular and Thoracic Annals)

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Late Migration of Percutaneous Bio‐Absorbable Devices—A Word of Caution

Journal of Cardiac Surgery — Mon, 05 Dec 2011 05:00:00 +0100

Conclusions: The overall incidence of perforation of cardiac structures due to secondary dislocation is low. However this complication exists and should kept in mind in symptomatic patients with new onset of chest pain, after percutaneous procedures. The concept of biodegradation, with residual, non absorbable metal braiding, should be reviewed, analyzing in particular long term results and incidence of secondary dislocation. (J Card Surg 2011; **:1‐3) (Source: Journal of Cardiac Surgery)

Anesthesia management of totally endoscopic atrial septal defect repair with a robotic surgical system

Journal of Clinical Anesthesia — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: The key issue for anesthetic management of robot-assisted totally endoscopic ASD repair is maintaining stable hemodynamics and oxygenation, especially during one-lung ventilation and capnothorax. (Source: Journal of Clinical Anesthesia)

Transcatheter aortic valve implantation and simultaneous closure of ostium secundum atrial septal defect.

The Heart Surgery Forum — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Pasic M, Berger F, D'Ancona G, Dreysse S, Buz S, Drews T, Hetzer R, Unbehaun A, Kukucka M Abstract We were faced with a difficult question: how to treat a high-risk patient with severe aortic valve stenosis and a secundum atrial septal defect (ASD II). An 85-year-old woman with progressive dyspnea and pedal edema and in New York Heart Association class IV was treated with concomitant transapical aortic valve implantation and transcatheter closure of the ASD II. The combined procedure and postoperative course were completely uneventful. At 2 years after the clinical follow-up, the patient is doing well. This case report demonstrates, for the first time, the feasibility, safety, and effectiveness of simultaneous application of 2 transcatheter methods-aortic valve implantatio...

Persistent left superior vena cava: Experience of a tertiary health‐care center

Pediatrics International — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion: Transthoracic echocardiography usually visualizes dilated coronary sinus in association with PLSVC. However, SVC injection should be performed in patients undergoing angiography so that morbidity and mortality related with persistent left superior vena cava can be avoided during cardiovascular surgery. (Source: Pediatrics International)

Transvenous Extraction of Pacemaker Leads in Infective Endocarditis With Vegetations ≥20 mm: Our Experience

Clinical Cardiology — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions:Transvenous extraction of pacing leads with larger vegetations is a feasible technique. There was a tendency toward symptomatic pulmonary embolism in patients with vegetations larger than 20 mm; however, morbidity and mortality were not influenced. We agree with the consensus that this procedure is highly useful and that the selection of the removal techniques will depend not only on the size of vegetation but also on prior cardiopulmonary conditions, concomitant cardiac surgery, atrial septal defect with risk of paradoxical embolism, center experience, and the possibility of complete removal of the device. © 2011 Wiley Periodicals, Inc.The authors have no funding, financial relationships, or conflicts of interest to disclose. (Source: Clinical Cardiology)

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Unusual Combination of Holt‐Oram Syndrome and Persistent Left Superior Vena Cava

Congenital Heart Disease — Wed, 30 Nov 2011 05:00:00 +0100

Conclusion. We report an uncommon association of HO and PLSVC. This association was only reported twice in the past and this is the first one that constitutes a casual finding during the attempt of CRT device implant. This is a combination that may complicate a device implant and recognition of it in advance may avoid performing potentially unsuccessful procedures. (Source: Congenital Heart Disease)

A deflectable guiding catheter for real‐time MRI‐guided interventions

Journal of Magnetic Resonance Imaging — Tue, 29 Nov 2011 05:00:00 +0100

Conclusion:Kevlar and short nitinol component substitutions preserved mechanical properties. The active design offered the best visibility and usability but reintroduced metal conductors. We describe versatile deflectable guiding catheters with a 0.057” lumen for interventional MRI catheterization. Implementations are feasible using active, inductive, and passive visualization strategies to suit application requirements. J. Magn. Reson. Imaging 2011. © 2011 Wiley Periodicals, Inc. (Source: Journal of Magnetic Resonance Imaging)

Ischemic Stroke Caused by Paradoxical Embolism After an Unsuccessful Transcatheter Atrial Septal Defect Closure Procedure: A Word of Caution

Pediatric Cardiology — Sat, 26 Nov 2011 16:46:31 +0100

Abstract Transcatheter device closure of atrial septal defect (ASD) has become a well-accepted alternative to surgical repair. Serious complications of transcatheter ASD closure are rare, but when they occur, devastating consequences may result. Herein, we present the case of a 4-year-old girl who had an ischemic stroke caused by a presumptive paradoxical embolism after an unsuccessful transcatheter ASD procedure and in whom subsequent venous color Doppler showed deep venous thrombosis (DVT) of the right lower extremity. The risk factors that predisposed to paradoxical cerebral embolism and DVT in this patient are discussed, and the literature is reviewed. Content Type Journal ArticleCategory Case ReportPages 1-4DOI 10.1007/s00246-011-0150-2Authors Zhen-fei Fang, Dep...

Pulmonary arteriovenous fistula in a patient with cryptogenic stroke

Heart — Thu, 24 Nov 2011 05:00:00 +0100

A 43-year-old female patient presented with transient right-sided facial numbness and dysarthria. MRI of the brain demonstrated an ischaemic infarct of the right medial occipital lobe. Embolic cerebral infarction was suspected, and transoesophageal echocardiography with injection of agitated saline was undertaken. This revealed microbubbles entering the left atrium (figure 1A,B) from the left upper pulmonary vein. There was no evidence of atrial septal defect or patent foramen ovale. Computed tomographic arteriography confirmed a pulmonary arteriovenous fistula (PAVF) originating from the left superior lingular segmental pulmonary artery and draining into the left upper pulmonary vein (figure 1C). There was no other clinical sign of hereditary haemorrhagic telangiectasia (HHT) and no mutat...

Surgical removal of fractured ATRIASEPT occluder 5 months after successful percutaneous closure of atrial septal defect [Images in cardio-thoracic surgery]

European Journal of Cardio-Thoracic Surgery — Wed, 23 Nov 2011 05:00:00 +0100

(Source: European Journal of Cardio-Thoracic Surgery)

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Early Thrombosis of a Tricuspid Annuloplasty Ring and Mild Hyperhomocysteinemia [CASE REPORTS]

The Annals of Thoracic Surgery — Wed, 23 Nov 2011 05:00:00 +0100

We present the case of a 40-year-old female with isolated mild hyperhomocysteinemia and early ring thrombus formation after surgical primary closure of an atrial septal defect and ring tricuspid annuloplasty. Clinical management, antithrombotic treatment, and hyperhomocysteinemia implications are discussed. (Source: The Annals of Thoracic Surgery)

A Growing Problem: Maternal Death and Peripartum Complications Are Higher in Women With Grown-Up Congenital Heart Disease [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

The Annals of Thoracic Surgery — Wed, 23 Nov 2011 05:00:00 +0100

Conclusions The GUCH parturients, especially those with VSD, have increased risk of mortality and peripartum complications compared with other age-matched women. Despite these risks, nearly 50% of GUCH patients deliver at nonteaching hospitals. Current national practice patterns for GUCH women are inadequate, and outcomes could be improved by education and proper triage of even relatively "simple" GUCH lesions such as atrial septal defect and VSD. Further studies that investigate risk-adjusted outcomes in a variety of care settings are necessary to resolve this complex issue. (Source: The Annals of Thoracic Surgery)

Quality of Life in Patients Undergoing Totally Thoracoscopic Closure for Atrial Septal Defect [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

The Annals of Thoracic Surgery — Wed, 23 Nov 2011 05:00:00 +0100

Conclusions Compared with conventional sternotomy, totally thoracoscopic atrial septal defect closure was associated with a faster recovery of physical function and a better quality of life. (Source: The Annals of Thoracic Surgery)

Closure of multiple fenestrations in an aneurismal atrial septum using overlapping GORE® HELEX septal occluders

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

We present the successful use of overlapping GORE® HELEX atrial septal defect occluders in an adult patient with 5 distinct fenestrations in an aneurismal septum and how 3D echo can aid device positioning. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Wire fractures in solysafe® septal occluders: a single center experience

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

Conclusions:The incidence of DF after iSSO unacceptably high. sF is imperative for accurate diagnosis of DF. Further follow‐up is needed to determine the risk of clinical complications and to optimize management. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

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Trisomy 18 mosaicism: report of two cases.

World Journal of Pediatrics : WJP — Mon, 21 Nov 2011 05:00:00 +0100

CONCLUSION: There is the possibility of good outcome for patients with mosaic trisomy 18, even in the presence of multiple congenital anomalies. PMID: 22105572 [PubMed - as supplied by publisher] (Source: World Journal of Pediatrics : WJP)

Renal cell carcinoma with right atrial extension with associated atrial septal defect: a case report

Indian Journal of Thoracic and Cardiovascular Surgery — Fri, 11 Nov 2011 12:48:23 +0100

We present a case of locally advanced renal cell carcinoma with tumor thrombus in the inferior vena-cava extending into the right atrium with associated atrial septal defect. Tumor removal posed a unique challenge in this patient as there was a risk of paradoxical embolism during the surgery. Content Type Journal ArticleCategory Case ReportPages 1-3DOI 10.1007/s12055-011-0120-6Authors Prashant Sevta, Department of Cardiothoracic & Vascular Surgery, G. B. Pant Hospital, New Delhi, IndiaSaket Agarwal, Department of Cardiothoracic & Vascular Surgery, G. B. Pant Hospital, New Delhi, IndiaSaket Singh, Department of Cardiothoracic & Vascular Surgery, G. B. Pant Hospital, New Delhi, IndiaSubodh Satyarthi, Department of Cardiothoracic & Vascular Surgery, G. B. Pant Hospital, New Delhi, In...

Tips and tricks to prevent prolapse of the amplatzer septal occluder through Large atrial septal defects

Catheterization and Cardiovascular Interventions — Wed, 09 Nov 2011 05:00:00 +0100

We report on a new technique “using a partially inflated balloon through the atrial septal defect” to prevent prolapse of the left atrial disk of the Amplatzer septal occulder in large atrial septal defects (ASDs). Two patients underwent successful closure of their ASDs using this new technique. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Evaluation of Right Ventricular Function in Early Period Following Transcatheter Closure of Atrial Septal Defect

Echocardiography — Tue, 08 Nov 2011 05:00:00 +0100

Conclusion: Closure of ASD by using Amplatzer devices led to decrease in right heart chamber size, tissue Doppler–derived tricuspid annular velocities and TAPSE in early period. (Echocardiography ****;**:1‐5) (Source: Echocardiography)

Identification and characterization of a complex pure mosaic of small supernumerary marker chromosomes involving 11p11.12 → q12.1 and 19p12 → q12 regions in a child featuring multiple congenital anomalies

American Journal of Medical Genetics Part A — Tue, 08 Nov 2011 05:00:00 +0100

AbstractUnstable, gene‐rich pericentric regions have been associated with various structural aberrations including small supernumerary marker chromosomes (sSMCs). We hereby report on a complex pure mosaic sSMCs derived from chromosomes 11 and 19 in a child featuring multiple congenital anomalies. As indicated by microarray analysis, the sSMCs have involved materials from 11p11.12 → q12.1 and 19p12 → q12 in complex forms (with four cell lines harboring from 1 to 4 sSMCs) in all peripheral blood lymphocytes. The patient featured facial dysmorphism, generalized hypotonia, cryptorchidism, transverse palmar creases, cerebral hemorrhage, atrial septal defect secundum, strabismus, epilepsy, immunodeficiency, and severe cognitive and motor impairment. Literature review indicated this...

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Neurohormonal and cytokine fluctuations following transcatheter closure for an atrial septal defect.

Cytokine — Tue, 08 Nov 2011 05:00:00 +0100

CONCLUSIONS: Transcatheter closure could improve, on a mid- term basis, the inflammatory process but natriuretic peptides' secretion continues in parallel with left atrial volume increase. Further follow up is required to determine the long-term progress of the inflammatory and neurohormonal response to the procedure. PMID: 22075401 [PubMed - as supplied by publisher] (Source: Cytokine)

Pulmonary artery sling: Current results with cardiopulmonary bypass

The Journal of Thoracic and Cardiovascular Surgery — Fri, 04 Nov 2011 04:00:00 +0100

Conclusions: Pulmonary artery sling is best repaired with median sternotomy, cardiopulmonary bypass, and left pulmonary artery reimplantation. This resulted in uniformly patent left pulmonary arteries in all patients. Preoperative computed tomography imaging, echocardiography, and bronchoscopy are essential for precise operative planning. The frequently associated tracheal stenosis is best repaired with slide tracheoplasty. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Over-Expression of DSCAM and COL6A2 Cooperatively Generates Congenital Heart Defects

PLoS Genetics — Thu, 03 Nov 2011 04:00:00 +0100

by Tamar R. Grossman, Amir Gamliel, Robert J. Wessells, Ouarda Taghli-Lamallem, Kristen Jepsen, Karen Ocorr, Julie R. Korenberg, Kirk L. Peterson, Michael G. Rosenfeld, Rolf Bodmer, Ethan Bier A significant current challenge in human genetics is the identification of interacting genetic loci mediating complex polygenic disorders. One of the best characterized polygenic diseases is Down syndrome (DS), which results from an extra copy of part or all of chromosome 21. A short interval near the distal tip of chromosome 21 contributes to congenital heart defects (CHD), and a variety of indirect genetic evidence suggests that multiple candidate genes in this region may contribute to this phenotype. We devised a tiered genetic approach to identify interacting CHD candidate genes. We first us...

Cor Triatriatum Dextro Iatrogenica: An Unusual Complication of Atrial Septal Defect Closure Device

Echocardiography — Wed, 02 Nov 2011 04:00:00 +0100

We present a case of a rare complication of atrial septal defect (ASD) device closure causing cor triatriatum dextro iatrogenica. A 29‐year‐old female presented with sudden onset dysarthria and ataxia and was found to have basilar and thalamic infarcts. Further evaluation using transthoracic echocardiography revealed an ASD which was repaired using the Gore HELEX septal occluder. Transesophageal echocardiography done after 2 months of ASD closure revealed an interesting finding termed cor triatriatum dextro iatrogenica. We briefly describe the case and discuss the relevant literature. (Echocardiography ****;**:E1‐E3) (Source: Echocardiography)

Deterioration of Mitral Valve Competence After the Repair of Atrial Septal Defect in Adults [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 01 Nov 2011 04:00:00 +0100

Conclusions Mitral valve competence may deteriorate after ASD closure in older patients with large ASD. (Source: The Annals of Thoracic Surgery)

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Oral presentation

Pacing and Clinical Electrophysiology : PACE — Tue, 01 Nov 2011 04:00:00 +0100

Conclusion: i.v. niferidile in doses up to 30 mkg/kg seems to be very effective (up to 88%) and safe for sinus rhythm restoration in patients with persistent AF and AFL.O002ELECTROPHYSIOLOGIC AND ANTIARRHYTHMIC EFFECTS OF NEW CLASS III AGENT NIFERIDILE IN PATIENTS WITH PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIASMironov NYu; Golitsyn SP; Sokolov SF; Yuricheva YuA; Maikov EB; Shlevkov NB; Rosetstraukh LV; Chazov EI  Russian cardiology research complexBackground: According to preclinical studies Niferidile (Nf) is a novel potassium channel blocker that inhibits transient outward and delayed rectifier currents and increases effective refractory periods (ERP) more in atria, less in ventricles. High affinity of Nf to atrial myocardium predispose to high efficacy in patients with supraventricular ...

Echocardiographic Diagnosis and Surgical Closure of Coronary Sinus Type of Atrial Septal Defect

Journal of Cardiac Surgery — Tue, 01 Nov 2011 04:00:00 +0100

Abstract Coronary sinus type of atrial septal defect (ASD CS) is a rare cardiac anomaly and is rarely diagnosed by only transthoracic echocardiography prior to surgical operation. We now describe a technique to treat this defect with the aid of two‐dimensional echocardiography, which prevents trauma to the conduction system and maintains drainage from the coronary sinus into the right atrium (RA). (J Card Surg 2011;26:653‐656) (Source: Journal of Cardiac Surgery)

Transcatheter Closure of a Large Atrial Septal Defect under Microprobe Transesophageal Echocardiographic Guidance

Echocardiography — Tue, 01 Nov 2011 04:00:00 +0100

We present a case of an atrial septal defect (ASD) in a 59‐year‐old man with an indication for ASD closure who also had a history of chronic obstructive pulmonary disease. Because of his decreased respiratory function with multiple bullae in his lungs, the procedure was performed without general anesthesia under the guidance of fluoroscopy and two‐dimensional (2D) transesophageal echocardiography (TEE) using a transesophageal echocardiographic microprobe (micro‐TEE) (S8‐3t; Philips Medical Systems, Andover, MA, USA). The micro‐TEE probe was inserted into the esophagus smoothly and easily in the supine position without sedation. It revealed a deficient superior‐anterior rim and adequate rims elsewhere, and the maximal diameter of ASD was measured to be 25 mm. Balloon sizing re...

Efficacy and Safety of Bosentan in Adults with Simple and Complex Eisenmenger's Syndrome

Congenital Heart Disease — Tue, 01 Nov 2011 04:00:00 +0100

Conclusions. Treatment with bosentan is both safe and effective in patients with both simple and complex forms of ES. (Source: Congenital Heart Disease)

The Modified Ablation Guided by Ibutilide Use in Chronic Atrial Fibrillation (MAGIC‐AF) Study:

Journal of Cardiovascular Electrophysiology — Fri, 28 Oct 2011 04:00:00 +0100

Conclusion:The MAGIC‐AF study will assess the utility of a combined pharmaco‐ablative strategy in patients with persistent AF undergoing a CFAE based ablation strategy.(J Cardiovasc Electrophysiol, Vol. pp. 1‐7) (Source: Journal of Cardiovascular Electrophysiology)

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The Role of Cardiovascular Magnetic Resonance in Adults with Congenital Heart Disease

Progress in Cardiovascular Diseases — Sat, 22 Oct 2011 01:47:04 +0100

Abstract: The comprehensive coverage and versatility of cardiovascular magnetic resonance (CMR), providing functional as well as anatomical information, make it an important facility in a center specializing in the care of adults with congenital heart disease. Imaging specialists using CMR to investigate acquired heart disease should also be able to recognize and evaluate previously unsuspected congenital malformations. Conditions that may present or be picked up during imaging in adulthood include atrial septal defect, anomalously connected pulmonary veins, double-chambered right ventricle, congenitally corrected transposition of the great arteries, aortic coarctation, and patent arterial duct. To realize its full potential and to avoid pitfalls, CMR of adults with congenital heart diseas...

Left main coronary artery compression by a giant pulmonary artery aneurysm associated with large atrial septal defect and severe pulmonary hypertension.

Anadolu Kardiyol Der... — Thu, 20 Oct 2011 14:20:19 +0100

Authors: Oz F, Emet S, Baykız D, Oflaz H PMID: 21967796 [PubMed - in process] (Source: Anadolu Kardiyol Der...)

Cor triatriatum sinister with secundum atrial septal defect in a patient with recurrent pulmonary infections.

Anadolu Kardiyol Der... — Thu, 20 Oct 2011 14:20:19 +0100

Authors: Işılak Z, Uzun M, Cay S PMID: 21967793 [PubMed - in process] (Source: Anadolu Kardiyol Der...)

Atrial septal defect with drainage of the inferior vena cava into the left atrium [Case reports]

European Journal of Cardio-Thoracic Surgery — Thu, 20 Oct 2011 04:00:00 +0100

We present a 17-year-old female with an ASD and an anomalous drainage of the IVC into the LA leading to cyanosis since early childhood. Diagnosis was documented by computed tomography (CT) angiography and confirmed intra-operatively. The patient underwent successful surgical correction with an uneventful postoperative course. (Source: European Journal of Cardio-Thoracic Surgery)

Five‐year Follow‐up of Intracardiac Echocardiography‐assisted Transcatheter Closure of Complex Ostium Secundum Atrial Septal Defect

Congenital Heart Disease — Thu, 20 Oct 2011 04:00:00 +0100

Conclusions. Intracardiac echocardiography‐guided complex secundum ASD transcatheter closure is safe and effective and appears to have excellent long‐term results, thus minimizing potential complications resulting from the complex anatomy. (Source: Congenital Heart Disease)

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How Do We Define Congenital Heart Defects for Scientific Studies?

Congenital Heart Disease — Thu, 20 Oct 2011 04:00:00 +0100

ABSTRACTEstimates of the prevalence of congenital heart defects (CHD) have been published over many years and from many regions. As they are based on different definitions of which cases to include in the CHD prevalence, published prevalence estimates vary substantially. With the increasing use of echocardiography in neonatal intensive care, a patent ductus arteriosus (PDA) or flow over the atrial septum will often be visible. These findings may be coded as CHD at discharge and in this way falsely increase the CHD prevalence in the population. There are several purposes for which population‐based data on CHD may be used: etiology, planning of treatment, or obtain information on outcome, including mortality. For etiology studies, it is important to include terminations of pregnancy as wel...

Horseshoe lung associated with left lung hypoplasia and single left pulmonary vein; a rare combination

Clinical Radiology — Wed, 19 Oct 2011 04:00:00 +0100

Horseshoe lung (HL) is a rare bronchovascular anomaly in which the posterobasal segments of the right and left lung are fused with a narrow isthmus of pulmonary parenchyma in a common pleural space behind the heart and anterior to the aorta and oesophagus. HL is mostly associated with unilateral lung hypoplasia (most frequently the right lung) in conjunction with the Scimitar syndrome and is also associated with cardiovascular anomalies, such as atrial septal defects, ventricular septal defects, tetralogy of Fallot, and hypoplastic left ventricule. HL with left lung hypoplasia is extremely rare, with only a few cases reported in the literature. To the authors’ knowledge, this is the first case of HL associated with left lung hypoplasia and a single left pulmonary vein as depicted using m...

Socioeconomic status and prevalence of congenital heart defects: Does universal access to health care system eliminate the gap?

Birth Defects Research Part A: Clinical and Molecular Teratology — Mon, 17 Oct 2011 04:00:00 +0100

DISCUSSION: It is assumed that increased ascertainment is responsible for observed increase in the prevalence of CHD, especially minor defects. While the trend and pattern over time changed for severe and nonsevere CHDs, the SES gap remained consistent during the study period. Our results indicate that even free and universal access to a health care system does not eliminate the SES gap observed in the prevalence of CHD. Birth Defects Research (Part A) 2011. © 2011 Wiley‐Liss, Inc. (Source: Birth Defects Research Part A: Clinical and Molecular Teratology)

The impact of cardiac surgery in patients with trisomy 18 and trisomy 13 in Japan

American Journal of Medical Genetics Part A — Tue, 11 Oct 2011 04:00:00 +0100

In this study, approximately a quarter of patients underwent surgery for CHD in both trisomies. Cardiac surgery may improve survival in selected patients with T18. © 2011 Wiley Periodicals, Inc. (Source: American Journal of Medical Genetics Part A)

Quality of Life in Patients Undergoing Totally Thoracoscopic Closure for Atrial Septal Defect.

The Annals of Thoracic Surgery — Mon, 10 Oct 2011 04:00:00 +0100

CONCLUSIONS: Compared with conventional sternotomy, totally thoracoscopic atrial septal defect closure was associated with a faster recovery of physical function and a better quality of life. PMID: 21992940 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)

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Fontan conversion with novel direct ablation after childbirth: Report of a case

Surgery Today — Tue, 04 Oct 2011 05:59:14 +0100

Abstract A 38-year-old woman underwent atriopulmonary Fontan surgery at age 18 years and subsequently successfully delivered a girl by cesarean section at age 34. Her condition later deteriorated due to atrial tachyarrhythmia and progressed to New York Heart Association (NYHA) class IV heart failure. Her treatment, at age 36, comprised total cavopulmonary connection conversion, direct right atrial ablation with bipolar radiofrequency devices, the creation of an atrial septal defect, and placement of a dual-chamber permanent pacemaker. Three years after the conversion, her condition has improved to NYHA class I. Content Type Journal ArticleCategory Case ReportPages 1684-1688DOI 10.1007/s00595-011-4560-9Authors Tsukasa Ozawa, Department of Cardiovascular Surgery, Toho U...

[Neonatal atrial tachycardia: Suggestive clinical sign of Costello syndrome].

Archives de Pediatrie — Sat, 01 Oct 2011 04:00:00 +0100

We describe herein two newborn infants with Costello syndrome revealed by atrial tachycardia associated with characteristic morphological and cardiac features of syndromes related to mutations in the RAS/MAPK pathway. PMID: 21885263 [PubMed - in process] (Source: Archives de Pediatrie)

Acute thrombus formation on an Amplatzer device during transcatheter closure of an atrial septal defect in a patient with homozygous factor V Leiden mutation.

Turk Kardiyoloji Dernegi arsivi — Sat, 01 Oct 2011 04:00:00 +0100

Authors: Yazıcıoğlu V, Sahin M, Karaca O, Türkmen M Abstract A 32-year-old woman underwent transcatheter closure of a secundum type atrial septal defect with the Amplatzer device. The procedure was started under premedication with aspirin, clopidogrel, and heparin. During the procedure, a highly mobile thrombus attached to the left atrial disc of the device was detected by transesophageal echocardiography (TEE). The device and the associated thrombus were successfully withdrawn and the patient was started on a combination of heparin and tirofiban infusion. The procedure was successfully completed without any recurrent thrombus formation or residual shunt. Further investigation for thrombophilia revealed homozygous factor V Leiden mutation and the patient was started on a life-l...

Partial anomalous pulmonary venous return and atrial septal defect in adult patients de-tected with 128-slice multidetector computed tomography

Journal of Cardiothoracic Surgery — Fri, 30 Sep 2011 04:00:00 +0100

The present series describes a group of adults with left-to-right shunts including partial anomalous pulmonary venous return PAPVR and/or an atrial septal defect (ASD) evaluated with ECG-gated 128-slice multidetector computed tomography (MDCT). PAPVR is defined as a left-to-right shunt where one or more, but not all, pulmonary veins drain into a systemic vein or the right atrium. PAPVR involving the right upper pulmonary vein can be associated with a sinus venosus ASD. The presence, course, number of anomalous veins and associated cardiovascular defects can be reliably observed by 128-slice MDCT angiography. (Source: Journal of Cardiothoracic Surgery)

Intraoperative Device Closure of Atrial Septal Defects in the Older Population

Journal of Cardiothoracic Surgery — Thu, 29 Sep 2011 04:00:00 +0100

This study sought to prove the safety and feasibility of intraoperative device closure of atrial septal defect (ASD) with transthoracic minimal invasion in the older patients.Methods From January 2006 to December 2009, 47 patients aged 50 years or more and suffered from atrial septal defect were enrolled in our institution. Patients were divided into two groups, 27 of which in group I with intraoperative device closure and the other 20 in group II with surgical closure. In group I, the method involved a minimal intercostal incision, which was performed after full evaluation of the atrial septal defect by transthoracic echocardiography, and the insertion of the device through the delivery sheath to occlude the atrial septal defect.Results In group I, implantation was ultimately successful i...

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New technique of off-pump atrial septostomy for complex congenital cardiac anomalies [Original articles]

European Journal of Cardio-Thoracic Surgery — Mon, 26 Sep 2011 04:00:00 +0100

Conclusions: This technique demonstrates the surgical feasibility of a beating-heart atrial septostomy. It avoids the adverse effects of cardiopulmonary bypass, reduces morbidity, and has no mortality. It is safe, economical, and easily reproducible. To our knowledge, this technique has not been reported in literature so far. (Source: European Journal of Cardio-Thoracic Surgery)

Persistent iatrogenic atrial septal defect after pulmonary vein isolation by cryoballoon: an under-recognized complication

Europace — Mon, 26 Sep 2011 04:00:00 +0100

Conclusions Persistent IASD is a common complication after PVI by cryoballoon catheter. Only left-to-right, but not right-to-left, interatrial shunting occurred as a result of the IASD. There was no clinical occurrence of paradoxical embolism. Patients should be screened for this complication after cryoballoon procedures and regular reassessment with echocardiographic or other techniques should be performed for monitoring. (Source: Europace)

Clinical Expression of an Inherited Unbalanced Translocation in Chromosome 6

Advances in Pharmacological Sciences — Sun, 25 Sep 2011 18:34:37 +0100

We report a family comprising of healthy and non-consanguineous young parents and their preemie newborn severely affected with congenital anomalies and systemic disorders. Conventional Gbanding analysis of somatic chromosomes identified a balanced translocation, t(6;10)(p23;q24), in mother and an unbalanced rearrangement, der(6)t(6:10)(p23;q24)mat, in the child. The child has inherited a derivative chromosome 6 with partial deletion of 6(p23-pter) and partial trisomy 10(q24-qter), which has resulted in fusion of genes of two different chromosomes. The prominent phenotypic features of del(6p), including high forehead, flat nasal bridge, agenesis of left ear, atrial septal defect (ASD), craniosynostosis, and growth retardation, are overlapping with specific Axenfeld-Reiger-, Larsen-, and Rit...

Transcatheter Closure of Atrial Septal Defect in a Patient with Cor Triatriatum Sinister and Atrial Septal Defect

Infectious Diseases in Obstetrics and Gynecology — Thu, 22 Sep 2011 16:26:01 +0100

Cor triatriatum sinister is a rare congenital heart disease and rarely found in adults. The authors describe an asymptomatic 20-year old man presenting with heart murmur by check up. Transthoracic and transesophageal echocardiogram demonstrate atrial septal defect (ASD) secundum 26 mm and cor triatriatum sinister with 20 mm of fenestration. Transcatheter closure of ASD using Occlutech FigullaR device was successfully performed without complications. Echocardiogram post procedure demonstrate good position of device without obstruction of blood flow, no residual shunt and residual 12 mm of fenestration of cor triatriatum. (Source: Infectious Diseases in Obstetrics and Gynecology)

Percutaneous atrial septal defect closure in a child with interrupted inferior vena cava: Successful femoral venous approach

Catheterization and Cardiovascular Interventions — Tue, 20 Sep 2011 04:00:00 +0100

We report our experience with successful transcatheter closure of a large residual atrial septal defect (ASD) using the femoral venous route in a 3‐year‐old patient with heterotaxy syndrome of left isomerism type, dextrocardia, partial atrioventricular canal defect, and interrupted IVC with azygous continuation to the SVC. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

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Prenatal Diagnosis of Mobile Flap‐Like Tissue on the Ventricular Septal Defect in a Newborn with Trisomy 18

Echocardiography — Mon, 19 Sep 2011 04:00:00 +0100

Trisomy 18 is the second most common autosomal trisomy in liveborn infants. Various congenital malformations, mental retardation, and high rate of infant mortality in the first year of life are characteristic features of trisomy 18. Congenital heart disease occurs in over 90% of these patients and the most common cardiac lesions are ventricular septal defect, patent ductus arteriosus and atrial septal defect. This is a case report of a baby born with trisomy 18 (postnatal diagnosis) in whom there was an unusual echocardiographic appearance of a mobile structure (“flap‐like”) around the area of a VSD—which was imaged prenatally. (Echocardiography, ****;**:E1‐E3) (Source: Echocardiography)

The short- and medium-term results of transcatheter closure of atrial septal defect with severe pulmonary arterial hypertension

Heart and Vessels — Fri, 16 Sep 2011 16:43:50 +0100

Abstract We investigated the short-term and medium-term results in patients with pulmonary arterial hypertension (PAH) associated with atrial septal defect (ASD) undergoing transcatheter closure. Fifteen patients with severe PAH associated with ASD who underwent successful occluder implantation from 2007 to 2010 were included. Clinical, echocardiographic, and hemodynamic data were reviewed. Severe PAH was defined as pulmonary arterial systolic pressure measured by catheterization was ≥60 mmHg and pulmonary vascular resistance (PVR) ≥6 Wood Units (WU). Compared with baseline, the 6-minwalking distance significantly increased by 29.7 ± 26.3 m (P < 0.001) at 3 months (short-term) and 65.4 ± 63.6 m (P < 0.001) at 23.4 ± 9.7 months (medium-term), World Health Organi...

Port-access heart surgery for the treatment of cor triatriatum with atrial septal defect: Report of a case

Surgery Today — Thu, 15 Sep 2011 15:53:03 +0100

Abstract A 40-year-old woman was admitted because of progressive dyspnea on exertion. Magnetic resonance imaging revealed an atrial septal defect and an abnormal membranous structure separating the left atrium into proximal and distal chambers. Surgical correction was performed by a minimally invasive surgical approach, i.e., port-access heart surgery, under the diagnosis of cor triatriatum (subtype of Lucas Schmidt IIIA1 or IB1) complicated with atrial septal defect. The postoperative course was uneventful, and she was discharged 12 days after surgery. This case is the first report of a surgical correction for cor triatriatum using the port-access technique. Content Type Journal ArticleCategory Case ReportPages 1418-1420DOI 10.1007/s00595-010-4431-9Authors Arudo Hir...

Percutaneous Radiofrequency Catheter Ablation for Atrial Fibrillation Prior to Atrial Septal Defect Closure

Journal of Cardiovascular Electrophysiology — Tue, 13 Sep 2011 04:00:00 +0100

We report on the management of 4 patients with recurrent medically refractory AF in the setting of an unrepaired ASD who underwent percutaneous RFA prior to ASD closure. In 3 of the 4 patients AF was controlled after ablation without antiarrhythmic drug therapy and in the fourth patient AF was controlled with antiarrhythmic therapy after ASD closure. Based on these limited results it seems reasonable to consider RFA of medically refractory AF in patients prior to planned percutaneous ASD closure. (J Cardiovasc Electrophysiol, Vol. pp. 1‐3) (Source: Journal of Cardiovascular Electrophysiology)

A “Small” Defect With Malignant Effect

Journal of the American College of Cardiology — Mon, 12 Sep 2011 19:05:15 +0100

A 24-year-old man presented with multiple trauma after an automobile accident. The treatment course was complicated by progressive respiratory failure with need for extracorporeal membrane oxygenation. Two-dimensional transesophageal echocardiography showed a small ostium secundum atrial septal defect (ASD) with atypical right-to-left-shunting (A, Online Video 1) and severe tricuspid valve regurgitation (B, Online Videos 2 and 3). Real-time 3-dimensional (3D) transesophageal echocardiography (X7-2t matrix-array probe, Philips Medical Systems, Best, the Netherlands) unmasked a large interatrial septal slit (C, Online Video 4), resulting in a hemodynamically relevant defect area (D, reconstruction of ASD diameters and orifice area). Because provisional ASD closure during cardiac catheterizat...

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Outcomes in adult congenital heart surgery: Analysis of the Society of Thoracic Surgeons Database

The Journal of Thoracic and Cardiovascular Surgery — Mon, 12 Sep 2011 04:00:00 +0100

Conclusions: Most adult congenital heart operations listed in the Society of Thoracic Surgeons Congenital Heart Surgery Database are performed in the third to fourth decades of life; approximately half are for right heart pathology or arrhythmia. Many patients have complications, but mortality is low with the exception of those undergoing Fontan revision/conversion. Many more adults undergoing congenital heart surgery are entered into the Society of Thoracic Surgeons Adult Cardiac Surgery Database. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Intermediate-Term Effects of Intracardiac Communications Created Noninvasively by Therapeutic Ultrasound (Histotripsy) in a Porcine Model

Pediatric Cardiology — Sat, 10 Sep 2011 15:41:28 +0100

Abstract The authors have demonstrated that histotripsy (pulsed cavitational ultrasound) can create atrial septal defects and ventricular septal defects (VSDs) in an open-chest canine model transcutaneously through the intact chest of neonatal pigs. To assess the potential untoward effects of these applications, the clinical, systemic, and pathologic effects of histotripsy-induced intracardiac communications were analyzed. Six neonatal pigs received noninvasive ultrasound therapy to their ventricular septa, then were allowed to survive 1 month for evaluation of intermediate-term effects. The results were compared with those of six previous animals killed immediately and three others killed 2–3 days after the procedure. Brain magnetic resonance imaging (MRI) and...

Frequency and spectrum of congenital heart defects among live births in Germany

Clinical Research in Cardiology — Sat, 10 Sep 2011 06:04:05 +0100

Conclusion The reported prevalences of severe CHD are within the range of regional and European comparative data. The prenatal detection rate of severe cardiovascular malformations is comparable to contemporary European registries. Postnatal diagnosis of the CHD has been made early in life. Content Type Journal ArticleCategory Original PaperPages 1-7DOI 10.1007/s00392-011-0355-7Authors Gerda Schwedler, Deutsches Herzzentrum Berlin—Kompetenznetz Angeborene Herzfehler, Augustenburger Platz 1, 13353 Berlin, GermanyAngelika Lindinger, Klinik fürPädiatrische Kardiologie, Universitätsklinikum des Saarlandes, 66421 Homburg/Saar, GermanyPeter E. Lange, Deutsches Herzzentrum Berlin—Kompetenznetz Angeborene Herzfehler, Augustenburger Platz 1, 13353 Berlin, GermanyUlric...

Long‐term survival in TARP syndrome and confirmation of RBM10 as the disease‐causing gene

American Journal of Medical Genetics Part A — Fri, 09 Sep 2011 04:00:00 +0100

AbstractTARP syndrome, comprising Talipes equinovarus, atrial septal defect (ASD), Robin sequence (micrognathia, glossoptosis, and cleft palate), and persistence of the left superior vena cava, is an X‐linked condition with pre‐ or postnatal lethality in affected males. Based on linkage studies and massively parallel sequencing of X‐chromosome exons in two families, the disease‐causing gene was identified as RBM10. We identified a maternally inherited frameshift mutation in an unrelated patient, confirming RBM10 as the disease gene. This is the first reported individual with TARP syndrome who survived past early infancy, thus expanding the phenotypic spectrum of this disorder. In addition to the characteristic cleft palate, ASD, and persistent superior vena cava, he had low‐set a...

Assessing the influence of consanguinity on congenital heart disease

Annals of Pediatric Cardiology — Thu, 08 Sep 2011 04:00:00 +0100

Alan H BittlesAnnals of Pediatric Cardiology 2011 4(2):111-116Numerous articles have been published linking consanguineous marriage to an elevated prevalence of congenital heart disease, with ventricular septal defects and atrial septal defects the most commonly cited disorders. While initially persuasive, on closer examination many of these studies have fundamental shortcomings in their design and in the recruitment of study subjects and controls. Improved matching of cases and controls, to include recognition of the long-established community boundaries within which most marriages are contracted, and the assessment of consanguinity within specific levels and types of marital union would improve and help to focus the study outcomes. At the same time, major discrepancies between studies in...

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Iatrogenic intra-atrial macro-reenterant tachycardia following transcatheter closure of atrial septal defect treated by radiofrequency ablation

Annals of Pediatric Cardiology — Thu, 08 Sep 2011 04:00:00 +0100

We describe a case of a 41-year-old patient in whom an Amplatzer septal occluder device was used to close a moderately large ASD and who subsequently developed incessant intra-atrial macro-reenterant tachycardia. The tachycardia was terminated by radiofrequency ablation guided by electroanatomical mapping. (Source: Annals of Pediatric Cardiology)

[Traumatic tricuspid valve insufficiency with right-to-left shunt : Bridging using extracorporeal venovenous membrane oxygenation.]

Der Anaesthesist — Thu, 08 Sep 2011 04:00:00 +0100

Authors: Weber SU, Hammerstingl C, Mellert F, Baumgarten G, Putensen C, Knuefermann P Abstract The case of a young male motor vehicle driver is reported who suffered multiple trauma in a car accident with pulmonary and cardiac contusions. In the course of severe pneumonia and traumatic tricuspid valve insufficiency a right-to-left shunt with refractory hypoxemia developed across a pre-existing atrial septal defect (ASD). The patient could be successfully treated by the combination of extracorporeal membrane oxygenation for bridging, interventional ASD occlusion and in the long-term by operative reconstruction of the tricuspid valve. PMID: 21901648 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)

Case 4/2011 - 49-year-old man with pulmonary valve stenosis and atrial septal defect as residual lesions after correction of tetralogy of Fallot, which occurred 30 years ago

Arquivos Brasileiros de Cardiologia — Tue, 06 Sep 2011 19:52:32 +0100

In conclusion, the small number of assessments of the incremental value of CRP, in conjunction with controversial results regarding the independent predictive value of CRP for short-term events does not support the recommendation of the routine use of CRP for risk stratification at admission of patients with ACS.A despecho de la asociación entre proteína C-reactiva de alta sensibilidad (PCR) y eventos recurrentes en síndromes coronarios agudos sin supradesnivel del segmento ST (SCA), la medida de rutina de este marcador no ha sido recomendada. Con el propósito de evaluar si las evidencias científicas actuales justifican la incorporación de la PCR para estratificación de riesgo en la admisión hospitalaria de pacientes con SCA, realizamos revisión sistemática y metanálisis de los ...

Defibrillator Wire Leads Traversing an Atrial Septal Defect

Journal of Diagnostic Medical Sonography — Mon, 05 Sep 2011 23:00:00 +0100

An implantable cardioverter defibrillator (ICD) is placed in the chest wall of patients who have reduced cardiac function and recurrent episodes of ventricular tachycardia or fibrillation. The purpose of the ICD is to detect life-threatening arrhythmias with subsequent cardioversion to a normal rhythm. Standard positioning of ICD leads are isolated to the right atrium and right ventricle, respectively. This case report documents an incidental but rare finding of an ICD lead traversing a suspected atrial septal defect in a patient with worsening dyspnea and a history of pulmonary embolism. Transthoracic echocardiography revealed what appeared to be a looped right atrial lead within the left atrium traversing the atrial septum, demonstrating an unusual ring appearance artifact. Subsequent im...

[Intracardiac echocardiography-guided device closure of atrial septal defects: our initial experience].

Turk Kardiyoloji Dernegi arsivi — Thu, 01 Sep 2011 04:00:00 +0100

CONCLUSION: Having high image quality and color Doppler features, ICE is quite functional in determining defect size, position of the septal occluder and its relationship with neighboring structures; thus, it is a reliable alternative to TEE which is used routinely in transcatheter closure of ASDs. PMID: 21918317 [PubMed - in process] (Source: Turk Kardiyoloji Dernegi arsivi)

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Supracardiac Total Anomalous Pulmonary Venous Connection with Severe Rheumatic Mitral Valve Disease

Journal of Cardiac Surgery — Thu, 01 Sep 2011 04:00:00 +0100

Abstract A rare association of supracardiac total anomalous pulmonary venous connection (TAPVC) along with severe rheumatic mitral regurgitation is presented. The patient, a 28‐year‐old female, underwent successful repair of the TAPVC along with pericardial patch closure of the atrial septal defect and replacement of the mitral valve with a mechanical prosthesis. (J Card Surg 2011;26:526‐528) (Source: Journal of Cardiac Surgery)

Outcome of caval division techniques for partial anomalous pulmonary venous connections to the superior vena cava.

The Annals of Thoracic Surgery — Wed, 31 Aug 2011 23:00:00 +0100

CONCLUSIONS: Caval division techniques appear to be effective, with low morbidity and mortality. The modified Warden procedure may decrease the risk of SVC obstruction. Late arrhythmias or PV obstruction are uncommon. PMID: 21871286 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Headache in 25 consecutive patients with atrial septal defects before and after percutaneous closure-a prospective case series.

Headache — Wed, 31 Aug 2011 23:00:00 +0100

The objectives of our study were (1) to determine headache prevalence in consecutive patients with ASD scheduled for percutaneous closure for cardiologic indications, using the International Classification of Headache Disorders and (2) to compare headache characteristics before and after closure of ASD. In this observational case series no a priori power analysis was performed. Twenty-five consecutive patients were prospectively included over 27 months. Median duration of follow-up was 12 months [interquartile range 0]. Prevalence of active headache seemed to be higher compared with the general population: any headaches 88% (95% confidence interval 70-96), migraine without aura 28% (14-48), migraine with aura 16% (6-35). After ASD closure, we observed a slightly lower headache frequency (m...

Outcome of Caval Division Techniques for Partial Anomalous Pulmonary Venous Connections to the Superior Vena Cava [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

The Annals of Thoracic Surgery — Tue, 30 Aug 2011 23:00:00 +0100

Conclusions Caval division techniques appear to be effective, with low morbidity and mortality. The modified Warden procedure may decrease the risk of SVC obstruction. Late arrhythmias or PV obstruction are uncommon. (Source: The Annals of Thoracic Surgery)

[Neonatal atrial tachycardia: Suggestive clinical sign of Costello syndrome.]

Archives de Pediatrie — Tue, 30 Aug 2011 04:00:00 +0100

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Lack of maternal folic acid supplementation is associated with heart defects in Down syndrome: A report from the National Down Syndrome Project

Birth Defects Research Part A: Clinical and Molecular Teratology — Tue, 23 Aug 2011 23:00:00 +0100

CONCLUSIONS: Our results suggest that lack of maternal folic acid supplementation is associated with septal defects in infants with Down syndrome. Birth Defects Research (Part A), 2011. © 2011 Wiley‐Liss, Inc. (Source: Birth Defects Research Part A: Clinical and Molecular Teratology)

Thrombus Formation during Percutaneous Closure of an Atrial Septal Defect with an Amplatzer Septal Occluder.

Texas Heart Institute Journal — Sat, 20 Aug 2011 10:44:06 +0100

Authors: Yorgun H, Canpolat U, Kaya EB, Aytemir K, Oto A Abstract Percutaneous closure of an ostium secundum-type atrial septal defect is typically a safe and effective therapeutic option in the presence of significant shunting or paradoxical embolism. Infrequently, however, periprocedural sequelae occur.Herein, we report the cases of 2 patients, each of whom underwent transcatheter closure of an atrial septal defect with the use of an Amplatzer Septal Occluder under transesophageal echocardiographic guidance. In both patients, acute thrombi formed periprocedurally, despite preprocedural anticoagulation. In patient 1, the infusion of unfractionated heparin for 24 hours prevented the recurrence of thrombus; in patient 2, the thrombus was isolated under the arm of the occluder, and u...

Left Ventricular Function in Adult Patients With Atrial Septal Defect: Implication for Development of Heart Failure After Transcatheter Closure

Journal of Cardiac Failure — Fri, 19 Aug 2011 04:00:00 +0100

Abstract: Despite advances in device closure for atrial septal defect (ASD), post-closure heart failure observed in adult patients remains a clinical problem. Although right heart volume overload is the fundamental pathophysiology in ASD, the post-closure heart failure characterized by acute pulmonary congestion is likely because of age-related left ventricular diastolic dysfunction, which is manifested by acute volume loading with ASD closure. Aging also appears to play important roles in the pathophysiology of heart failure through several mechanisms other than diastolic dysfunction, including ventricular systolic and vascular stiffening and increased incidence of comorbidities that significantly affect cardiovascular function. Recent studies suggested that accurate assessment of preclos...

Right ventricular volume unloading evaluated by tangential magnetocardiography

General Thoracic and Cardiovascular Surgery — Wed, 17 Aug 2011 05:48:51 +0100

Conclusions: We conclude that acute volume unloading of the right ventricle was indicated quantitatively by shortening of the right ventricular depolarization time and a reduction in the amplitude of current vectors originating from the right ventricular depolarization on the tangential magnetocardiography. Content Type Journal ArticleCategory Original ArticlePages 16-23DOI 10.1007/BF03218080Authors Yasushi Terada, Department of Cardiovascular Surgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, 305-8575 Ibaraki, JapanToshio Mitsui, Department of Cardiovascular Surgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, 305-8575 Ibaraki, JapanMasato Sato, Department of Cardiovascular Surgery, Institute of Clinical Medicine, University of Tsukuba, T...

Transthoracic echocardiographic guidance during transcatheter closure of atrial septal defects in children and adults

The International Journal of Cardiovascular Imaging — Thu, 11 Aug 2011 06:02:02 +0100

Abstract The purpose of this study was to evaluate the safety and efficacy of transcatheter Atrial septal defect (ASD) closure guided by transthoracic echocardiography (TTE). Since 2004, ASD closure was performed successfully in total 337 patients. Transthoracic echocardiography guidance was used in 206 patients (61.1%) (group 1). Closure was guided by transesophageal echocardiography under general anesthesia in patients with poor transthoracic acoustic windows, defects with aneurysmatic septum and/or multiple defects in 131 patients (38.9%) (group 2). The median age (9 vs. 16 years, P < 0.001), mean defect diameter (14.9 ± 4 vs. 17.2 ± 5 mm, P < 0.001), ratio of complex atrial septal defect (14 vs. 34%, P = ...

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Repairing Interatrial Septal Defects From the Operating Room to the Cardiac Catheterization Laboratory: 2D or Not 2D?

Seminars in Cardiothoracic and Vascular Anesthesia — Wed, 10 Aug 2011 23:00:00 +0100

Uncorrected congenital interatrial septal defect can be found in nearly a third of all adults and are associated with significant morbidity, including pulmonary hypertension, right-heart failure, atrial arrhythmias, and paradoxical embolic stroke. With advancing technology, percutaneous closure of atrial septal defects has become a viable alternative to open surgical repair. In this review, the authors provide 3 examples in which 3-dimensional interventional transesophageal echocardiogram effectively provided more precise visualization of the dynamic surface and geometry of the atrial septum and related structures than 2-dimensional TEE, permitting accurate sizing and repair of the defects. (Source: Seminars in Cardiothoracic and Vascular Anesthesia)

Pulmonary Emphysematous Changes in Patients with Congenital Heart Disease Associated with Increased Pulmonary Blood Flow: Evaluation Using Multidetector-Row Computed Tomography

Heart, Lung and Circulation — Wed, 10 Aug 2011 16:28:59 +0100

Conclusion: MDCT can provide accurate detection of segmental emphysema in patients with CHD. Emphysematous change is not uncommon pathological lesion in children and adolescents with CHD. (Source: Heart, Lung and Circulation)

A Novel Bilayer Approach to Ventricular Septal Deformation Analysis by Speckle Tracking Imaging in Children with Right Ventricular Overload

Journal of the American Society of Echocardiography — Mon, 08 Aug 2011 04:00:00 +0100

Conclusions: Deformation of both sides of the ventricular septum functionally differed. Bilayer analysis of the ventricular septum can help in the evaluation of right ventricular performance under volume and pressure overload. (Source: Journal of the American Society of Echocardiography)

Biliary atresia with associated structural malformations in Canadian infants

Liver International — Sat, 06 Aug 2011 23:00:00 +0100

Conclusion: We suggest that the acronym ‘BASM’ be redefined as ‘biliary atresia structural malformation’. (Source: Liver International)

Imaging of atrial septal defects: echocardiography and CT correlation

Heart — Thu, 04 Aug 2011 23:00:00 +0100

Adult patients with atrial septal defects (ASDs) have variable clinical presentations that can range from dyspnoea on exertion to cerebral vascular accidents from paradoxical embolism. Currently echocardiography is the mainstay in the diagnosis and follow-up of patients with ASDs. As CT technology advances and low radiation techniques improve, cardiac CT is becoming a desirable method to evaluate patients with ASDs when echocardiographic evaluation is limited. Correct diagnosis and appropriate management of patients with patent foramen ovales (PFOs) and ASDs relies on an understanding of the embryologic development patterns that resulted in the malformation and associated anomalies. In this review, we illustrate the development of the interatrial septum and the foramen ovale. We discuss th...

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Maternal age and prevalence of isolated congenital heart defects in an urban area of the United States

American Journal of Medical Genetics Part A — Tue, 02 Aug 2011 23:00:00 +0100

AbstractAlthough maternal age has been associated with a number of birth defects in several reports, the literature on the association of maternal age with isolated congenital heart defect (CHD) phenotypes has been limited. We evaluated CHD prevalence based on a cohort of 5,289 infants and fetuses with isolated CHDs born during the period 1968–2005 and ascertained by the Metropolitan Atlanta Congenital Defects Program (MACDP) among residents of five central counties in Atlanta. For our denominator, we obtained information on births to residents of the same counties from vital records (n = 1,301,143). We calculated prevalence ratios for 23 CHD phenotypes by several maternal age categories, using the group 25–29 years of age as a reference group. We used Poisson regression models to ...

Persistent left superior vena cava: experience of a tertiary health care center

Pediatrics International — Mon, 01 Aug 2011 23:00:00 +0100

Conclusion: TTE usually visualizes dilated coronary sinus in association with PLSVC. However, SVC injection should be performed in patients undergoing angiography so that morbidity and mortality related with persistent left superior vena cava can be avoided during cardiovascular surgery. (Source: Pediatrics International)

Feasibility of transcatheter closure in unselected patients with secundum atrial septal defect, using amplatzer devices and a modified sizing balloon technique

Catheterization and Cardiovascular Interventions — Mon, 01 Aug 2011 23:00:00 +0100

Conclusion: The majority of secundum atrial septal defect is amenable to transcatheter closure, using a modified implantation technique in 16% of cases. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Congenital Right Pulmonary Artery Agenesis with Atrial Septal Defect and Pulmonary Hypertension

Congenital Heart Disease — Sat, 30 Jul 2011 23:00:00 +0100

ABSTRACTUnilateral pulmonary artery agenesis is a rare congenital anomaly caused by a backward displacement of the conical artery of the truncus arteriosus. It is commonly associated with additional cardiovascular abnormalities. A 7‐year‐old girl was admitted to our clinic with the complaint of shortness of breath upon exertion. Chest radiography revealed a hypoplastic right lung. Absence of the right pulmonary artery with atrial septal defect and pulmonary hypertension was demonstrated by echocardiography, computed tomography, and cardiac catheterization. Bosentan is effectively used to treat pulmonary arterial hypertension. (Source: Congenital Heart Disease)

Taming the “cobra”: An approach to “Cobra‐Like” formation seen in the occlutech atrial septal defect and patent foramen ovale occluders

Catheterization and Cardiovascular Interventions — Fri, 29 Jul 2011 04:00:00 +0100

We present a small series of four cases in which a “cobra‐like” formation occurred in an Occlutech Figulla device during the deployment of the left disk, and propose a technique that may resolve this problem. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

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Tulip malformation of the left atrial disc in the lifetech cera ASD device: A novel complication of percutaneous ASD closure

Catheterization and Cardiovascular Interventions — Thu, 28 Jul 2011 23:00:00 +0100

AbstractA previously unreported tulip‐like malformation of the left atrial disc was encountered during percutaneous closure of an atrial septal defect using the LifeTech Cera ASD device, requiring snare assistance to permit recapture into the delivery sheath. This was likely a result of attempting recapture the left atrial disc whilst it remained in contact with some part of the atrial septum or left atrial wall. To help avoid this, it is recommended to ensure complete intracavity positioning of the Cera device prior to retrieval into the sheath. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Taming the “cobra”: An approach to “cobra” like formation seen in the occlutech atrial septal defect and patent foramen ovale occluders

Catheterization and Cardiovascular Interventions — Thu, 28 Jul 2011 23:00:00 +0100

We present a small series of four cases in which a “cobra” like formation occurred in an Occlutech Figulla device during the deployment of the left disk, and propose a technique that may resolve this problem. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

A comparative study of cardi‐o‐fix septal occluder versus amplatzer septal occluder in percutaneous closure of secundum atrial septal defects

Catheterization and Cardiovascular Interventions — Thu, 28 Jul 2011 23:00:00 +0100

Conclusion:Transcatheter ASD occlusion with CSO is safe and effective and it appeared to be an attractive alternative to ASO in closing simple‐type ASD because of its relatively low cost. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Novel Biodegradable Polycaprolactone Occlusion Device Combining Nanofibrous PLGA/Collagen Membrane for Closure of Atrial Septal Defect (ASD).

Annals of Biomedical Engineering — Thu, 28 Jul 2011 23:00:00 +0100

Authors: Liu SJ, Peng KM, Hsiao CY, Liu KS, Chung HT, Chen JK The purpose of this report was to develop novel biodegradable occlusion devices for closure of atrial septal defects (ASD). To manufacture the biodegradable occluders, polycaprolactone (PCL) components were first fabricated by a lab-scale micro-injection molding machine. They were then assembled and hot-spot welded into double umbrella-like devices of 50 mm in diameter. A special mechanism at the axis of the occluder was designed to self-lock the occluder after the two umbrellas were expanded. Furthermore, a nanofibrous matrix of poly-D: -L: -lactide-glycolide (PLGA)/type I collagen blend was produced via electrospinning to develop biodegradable and biomimetic anti-shunt membranes for the occluders. Characterization of the ...

[Percutaneous closure of interatrial septal defects: mid-term follow-up results.]

Turk Kardiyoloji Dernegi arsivi — Tue, 26 Jul 2011 00:30:03 +0100

CONCLUSION: Percutaneous closure of secundum ASDs and PFOs using the Amplatzer, Occlutech Figulla, and BioSTAR devices is an effective and safe treatment option. PMID: 21743262 [PubMed - as supplied by publisher] (Source: Turk Kardiyoloji Dernegi arsivi)

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Mixed Atrial Septal Defect: Coexisting Ostium Secundum and Sinus Venosus Atrial Septal Defect

Journal of the American College of Cardiology — Sat, 23 Jul 2011 15:21:06 +0100

A 62-year-old man presented with symptoms and signs of right-sided heart failure. Echocardiography revealed severe right-heart dilation and moderate pulmonary artery hypertension (pulmonary artery systolic pressure 55 mm Hg). Transesophageal echocardiography demonstrated both a sinus venosus atrial septal defect and a secundum atrial septal defect (A, B, Online Videos 1 and 2), with a predominant left-to-right shunt and a brief right-to-left shunt (C, Online Videos 3 and 4). Also, the right superior pulmonary vein was found to be anomalously draining into the superior vena cava (broken ring sign) (D, Online Video 5). The patient underwent successful surgical repair of the defects and also an atrial fibrillation ablation procedure. (Source: Journal of the American College of Cardiology)

The origins of open heart surgery at the University of Minnesota 1951 to 1956

The Journal of Thoracic and Cardiovascular Surgery — Fri, 22 Jul 2011 03:55:46 +0100

As a senior medical student in May 1951, I recall the excitement in the surgery department when Dr Clarence Dennis, who later became Chairman at Downstate University in New York, and his staff were in an operating suite to repair an atrial septal defect in a child by using open heart surgical techniques. They were using a heart–lung machine of the team’s design; later, a second procedure was performed, but neither effort was successful. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Endobronchial Closure of Bronchopleural Fistula with Amplatzer PFO Device

The Thoracic and Cardiovascular Surgeon — Tue, 19 Jul 2011 23:00:00 +0100

Thorac cardiovasc SurgDOI: 10.1055/s-0031-1280005AbstractBronchopleural fistula (BPF) is a feared postoperative complication of pneumonectomy that carries significant morbidity and mortality. BPF can be treated by various surgical and medical techniques. Endobronchial techniques have been used for the delivery of biological glue, sealants, coils, and covered stents with variable degrees of success, depending on the size of the fistula. A recent case report described the endobronchial closure of a BPF through the implantation of an Amplatzer ASD device, commonly used for transcatheter closure of atrial septal defects. In this case report, we describe closure of a BFP using the Amplatzer PFO device.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of conte...

Endobronchial Closure of Bronchopleural Fistula with Amplatzer PFO Device.

The Thoracic and Cardiovascular Surgeon — Tue, 19 Jul 2011 23:00:00 +0100

Authors: Krumpolcova M, Durand M, Rossi-Blancher M, Heylbroeck C, Vanzetto G, Albaladejo P, Brichon PY Bronchopleural fistula (BPF) is a feared postoperative complication of pneumonectomy that carries significant morbidity and mortality. BPF can be treated by various surgical and medical techniques. Endobronchial techniques have been used for the delivery of biological glue, sealants, coils, and covered stents with variable degrees of success, depending on the size of the fistula. A recent case report described the endobronchial closure of a BPF through the implantation of an Amplatzer ASD device, commonly used for transcatheter closure of atrial septal defects. In this case report, we describe closure of a BFP using the Amplatzer PFO device. PMID: 21776586 [PubMed - as supplied by...

Development and clinical application of minimally invasive cardiac surgery using percutaneous cardiopulmonary support

General Thoracic and Cardiovascular Surgery — Fri, 15 Jul 2011 16:04:10 +0100

Conclusions: Minimally invasive cardiac surgery using percutaneous cardiopulmonary support is safe and an excellent option for selected patients affected by single valve lesion, simple cardiac anomalies, and coronary artery bypass grafting. Content Type Journal ArticlePages 562-567DOI 10.1007/BF03218201Authors Hiroshi Ohuchi, Department of Surgery, Saitama Medical School, 38 Morohongo, Moroyama, 350-0495 Saitama, JapanShunei Kyo, Department of Surgery, Saitama Medical School, 38 Morohongo, Moroyama, 350-0495 Saitama, JapanHaruhiko Asano, Department of Surgery, Saitama Medical School, 38 Morohongo, Moroyama, 350-0495 Saitama, JapanHiroaki Tanabe, Department of Surgery, Saitama Medical School, 38 Morohongo, Moroyama, 350-0495 Saitama, JapanYuji Yokote, Department of Surgery, Saitama ...

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Surgical management of aortopulmonary window

General Thoracic and Cardiovascular Surgery — Fri, 15 Jul 2011 16:04:02 +0100

Conclusions: The surgical results for an aortopulmonary window are encouraging, even if such patients are associated with major cardiac anomalies and an interrupted aortic arch. Most have shown a good long-term outcome. Content Type Journal ArticlePages 557-561DOI 10.1007/BF03218200Authors Yoshihisa Tanoue, Department of Cardiovascular Surgery, Kyushu Kosei-Nenkin Hospital, 2-1-1 Kishinoura, Yahatanishi-ku, 806-8501 Kitakyushu, JapanAkira Sese, Department of Cardiovascular Surgery, Kyushu Kosei-Nenkin Hospital, 2-1-1 Kishinoura, Yahatanishi-ku, 806-8501 Kitakyushu, JapanYasutaka Ueno, Department of Cardiovascular Surgery, Kyushu Kosei-Nenkin Hospital, 2-1-1 Kishinoura, Yahatanishi-ku, 806-8501 Kitakyushu, JapanKunitaka Joh, Department of Cardiovascular Surgery, Kyushu Kosei-Nenkin ...

Volume Overload and Pressure Overload due to Left-to-Right Shunt-Induced Myocardial Injury.

Circulation Journal — Wed, 13 Jul 2011 23:00:00 +0100

Conclusions: Significant volume and pressure overload due to a left-to-right shunt induce myocardial injury and might eventually cause irreversible myocardial remodeling in children with CHD. The serum cTnI level is a useful biomarker for evaluating myocardial damage associated with pulmonary hypertension in VSD children. PMID: 21757825 [PubMed - as supplied by publisher] (Source: Circulation Journal)

Preoperative autologous donation of blood in cardiac surgery —Age related factors—

General Thoracic and Cardiovascular Surgery — Wed, 13 Jul 2011 06:11:23 +0100

Abstract We have studied influence of the age related factors on preoperative autologous donation (PAD) of blood in cardic surgery. PAD was undertaken in 246 cases of elective cardiac surgery by means of simple or leap-frog method, starting at approximately 4.5 weeks before operation. It provided 1726 ml of autologous blood storage on the average. Sorting the patients into three groups with age, leading surgical procedures were as follows: closure of the atrial septal defect (ASD) in teen-30s (group L, n=51), aortic valve replacement (AVR) or mitral valve replacement (MVR) in 40s–50s (group M, n=83) and 60s and over (group H, n = 112). Coronary artery bypass grafting (CABG) was more common in group H. Percent-freedom from allogeneic blood transfusion was 82.3% in group L...

A successful case report of one and one half ventricle repair for pure pulmonary stenosis in a 4-year-old girl

General Thoracic and Cardiovascular Surgery — Wed, 13 Jul 2011 05:57:57 +0100

Abstract A 4-year-old girl with pure pulmonary stenosis, hypoplastic right ventricle and atrial septal defect, underwent left modified Blalock-Taussig shunt at the age of 2 year. Her RVEDV was 62.7% of normal and TVD was 64.2% of normal at the age of 3 year. We observed development of right ventricle and performed simultaneously Glenn shunt and right ventricular outflow reconstruction (one and one half ventricle repair). Her general condition after operation became better. The size of tricuspid valve and right ventricle grew on Cardiac ultrasonography and catheterization examined after one year operation. In futur,If the size of RV and TV might grow further, we should recommend her biventricular repair. Content Type Journal ArticlePages 933-938DOI 10.1007/BF03217849Aut...

Late Infective Endocarditis of an Atrial Septal Occluder Device Presenting as a Cystic Mass

Echocardiography — Thu, 30 Jun 2011 23:00:00 +0100

We report an atypical echocardiographic presentation of a vegetation in a patient with late infective endocarditis of an atrial septal defect (ASD) occluder device. Transesophageal echocardiography demonstrated a penduculated mass attached to the left atrial side of the occluder device. This mass presented as an oscillating echo free area surrounded by a membrane attached to the device by a thin stalk. At time of surgical excision, the lesion did not present as a spherical cyst. It was assumed that the content of the echo free mass had already emptied into the left atrium. Histopathology diagnosed the mass as a vegetation. The contribution of contrast echocardiography to the evaluation of intracardiac masses is briefly discussed. (Echocardiography 2011;**:E1‐E3) (Source: Echocardiograp...

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Transcatheter Elimination of Left‐to‐Right Shunts in Infants with Bronchopulmonary Dysplasia Is Feasible and Safe

Congenital Heart Disease — Thu, 30 Jun 2011 23:00:00 +0100

Conclusion. Transcatheter occlusion of L–R shunts can be performed safely and effectively in children with BPD. Further studies may clarify the role of such therapy in improvement in respiratory physiology over time. (Source: Congenital Heart Disease)

Impact of transcatheter closure of atrial septal defects in pediatric patients on body weight.

J Formos Med Assoc — Thu, 30 Jun 2011 23:00:00 +0100

This study aimed to investigate body weight changes in pediatric patients after transcatheter closure of ASD. PMID: 21742251 [PubMed - in process] (Source: J Formos Med Assoc)

Surgical Closure of Sinus Venosus Atrial Septal Defect Using A Single Patch—Transcaval Repair Technique

Journal of Cardiac Surgery — Thu, 30 Jun 2011 23:00:00 +0100

Conclusion: We conclude that this technique is safe and simple for the repair of selected cases of sinus venosus atrial septal defect with partial anomalous pulmonary venous connection and it preserves the sinoatrial node function after surgery. (J Card Surg 2011;26:429‐434) (Source: Journal of Cardiac Surgery)

High-dose fenoldopam reduces post operative neutrophil gelatinase associated lipocaline and cystatin C levels in pediatric cardiac surgery

Critical Care — Tue, 28 Jun 2011 23:00:00 +0100

Conclusions: The treatment with high-dose fenoldopam during CPB in pediatric patients undergoing cardiac surgery for CHD with biventricular anatomy significantly decreased urinary levels of NGAL and CysC and reduced the use of diuretics and vasodilators during CPB.Trial registration: Clinical Trial.Gov NCT00982527. (Source: Critical Care)

Ablation of Nkx2-5 at mid-embryonic stage results in premature lethality and cardiac malformation

Cardiovascular Research — Mon, 27 Jun 2011 23:00:00 +0100

Conclusion Nkx2-5 is necessary for survival after the mid-embryonic stage for cardiac function and formation by regulating the expression of its downstream target genes. (Source: Cardiovascular Research)

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Transseptal puncture through atrial septal closure devices

Heart Rhythm — Mon, 27 Jun 2011 04:00:00 +0100

Ostium secundum defects involve the region of the fossa ovalis and represent 80% of all atrial septal defects (ASDs). They account for approximately 7% of all congenital malformations. Small defects (1.5), right atrial/right ventricular enlargement, and paradoxical embolism are the main indications for ASD closure. Recently, device closure has emerged as the treatment of choice for secundum ASD when the anatomy is suitable. (Source: Heart Rhythm)

Reoperation and Mechanical Circulatory Support After Repair of Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery: A Twenty-Year Experience [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

The Annals of Thoracic Surgery — Sun, 26 Jun 2011 23:00:00 +0100

Conclusions Overall survival is excellent after ALCAPA repair. However, those patients who require mechanical support after repair appear to be at higher risk for transplantation or reoperation, typically for mitral regurgitation. (Source: The Annals of Thoracic Surgery)

Totally Thoracoscopic Surgical Closure of Atrial Septal Defect in Small Children [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

The Annals of Thoracic Surgery — Sun, 26 Jun 2011 23:00:00 +0100

Conclusions Totally thoracoscopic surgical atrial septal defect closure in small children is feasible, minimally invasive, safe, and has good cosmesis. (Source: The Annals of Thoracic Surgery)

Early and long-term outcome of surgery for cardiac myxoma: experience of a single cardiac surgical centre.

Kardiologia Polska — Sun, 26 Jun 2011 17:30:03 +0100

Conclusions: Surgery for cardiac myxoma is associated with low long-term mortality and morbidity. Functional status following operation improved significantly after surgery. Kardiol Pol 2011; 69, 6: 558-564. PMID: 21678290 [PubMed - in process] (Source: Kardiologia Polska)

Perioperative Care of a Child with Transposition of the Great Arteries

Current Treatment Options in Cardiovascular Medicine — Fri, 24 Jun 2011 16:03:49 +0100

Opinion statement Because a minority of patients with D-transposition of the great arteries are diagnosed in utero by ultrasound, most present after delivery with cyanosis. In the absence of apparent lung disease, cyanotic neonates suspected of having a cardiac lesion should be immediately transferred to an intensive care unit at a pediatric tertiary care center for monitoring, resuscitation, and to define the cardiac anatomy and physiology. A prostaglandin E-1 infusion is usually initiated to maintain ductal patency and promote intra-cardiac mixing. In the past, balloon atrial septostomy (BAS) was routinely performed to enlarge the atrial septal defect and improve intra-cardiac mixing while the infants awaited surgery. Recent literature has reported an increase risk of st...

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Observed Prevalence of Congenital Heart Defects From a Surveillance Study in China

Journal of Ultrasound in Medicine — Thu, 23 Jun 2011 23:00:00 +0100

Conclusions— The prevalence of all congenital heart defects in the 4 areas of China studied was higher than that reported in other countries, with ventricular septal defects being the most frequent defects. Our data likely reflect a better estimate of the total prevalence of congenital heart defects in China than reported previously. (Source: Journal of Ultrasound in Medicine)

Transseptal access and atrial fibrillation ablation guided by intracardiac echocardiography in patients with atrial septal closure devices

Heart Rhythm — Thu, 23 Jun 2011 04:00:00 +0100

Background: Percutaneous positioning of closure devices is a well-established treatment of atrial septal defects (ASDs). However, patients who have undergone the procedure are at increased risk for developing atrial fibrillation (AF), and treatment by catheter ablation is underutilized due to the perceived difficulty of obtaining transseptal access in the presence of the closure device.Objective: The purpose of this study was to report the acute and long-term results of radiofrequency catheter ablation of AF in patients with ASD closure devices.Methods: Thirty-nine patients (age 54 ± 6 years, 72% males) with drug-refractory AF (33% paroxysmal, 51% persistent, 16% long-standing persistent) and ASD closure devices (82% Amplatzer, 18% CardioSEAL) underwent radiofrequency catheter ablation. A...

Cardiopulmonary Exercise Testing and SF-36 In Patients With Atrial Septal Defect Type Secundum.

Journal of Cardiopulmonary Rehabilitation and Prevention — Wed, 22 Jun 2011 23:00:00 +0100

CONCLUSION:: Patients with open and closed ASD had decreased peak V[Combining Dot Above]O2. Patients with open ASD had lower ventilatory efficiency. Closed ASD patients had chronotropic incompetence because of β-blockers. SF-36 was reduced in patients with open ASD but not closed ASD. Reduced exercise capacity affected several domains of perceived health-status in ASD patients. PMID: 21705914 [PubMed - as supplied by publisher] (Source: Journal of Cardiopulmonary Rehabilitation and Prevention)

Defect closure in the lipomatous hypertrophied atrial septum with the amplatzer muscular ventricular septal defect closure device: A case series

Catheterization and Cardiovascular Interventions — Fri, 17 Jun 2011 01:20:56 +0100

We present a novel technique exploiting the features of the Amplatzer muscular ventricular septal defect occluder to treat atrial septal defects in the setting of lipomatous hypertrophy of the atrial septum in two patients. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Platypnea-Orthodeoxia Syndrome: What Is the Driving Force?

The American Journal of the Medical Sciences — Wed, 15 Jun 2011 23:00:00 +0100

Authors: Edwards AL, Cornatzer E, Shelton RW A 69-year-old patient presented with episodic, acute hypoxia and an increasing oxygen requirement. His hemoglobin oxygenation reached its nadir in the 80% to 85% range as measured by pulse oximetry while he was sitting upright. Oxygenation would improve in this patient to percentages in the upper 90s when he was in the supine position. He was found to have a large secundum atrial septal defect with bidirectional intracardiac shunting, left hemidiaphragmatic dysfunction, a dilated ascending aorta and a prominent Eustachian valve. The patient was stabilized with oxygen therapy, and the cardiology service provided definitive treatment via percutaneous shunt closure with a septal occluder. PMID: 21685783 [PubMed - as supplied by publisher] (...

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The Efficacy and Safety of Sildenafil in Patients With Pulmonary Arterial Hypertension Associated With the Different Types of Congenital Heart Disease

Clinical Cardiology — Tue, 14 Jun 2011 23:00:00 +0100

Conclusions:Sildenafil therapy seems to be effective and safe for PAH secondary to ASD, VSD, and PDA, although some clinical and hemodynamic parameters were changed in a different manner among the 3 groups. © 2011 Wiley Periodicals, Inc.This study was partly supported by National Grant from The Ministry of Science and Technology (2006BAI01A07) and Capital Development Scientific Fund (2005‐1018). The authors have no other funding, financial relationships, or conflicts of interest to disclose.Study Group participants are listed in the Supporting Information Appendix. (Source: Clinical Cardiology)

Management of Symptomatic Inadvertently Placed Endocardial Leads in the Left Ventricle

Pacing and Clinical Electrophysiology : PACE — Mon, 13 Jun 2011 23:00:00 +0100

Conclusion:The avoidance and early recognition of inadvertently placed endocardial leads in the LV is imperative in order to avoid potentially serious sequelae and invasive interventions. Treatment usually consists of surgical extraction, although anticoagulation and percutaneous simple traction techniques are an option in certain scenarios. (PACE 2011; 1–8) (Source: Pacing and Clinical Electrophysiology : PACE)

Interventional creation of an atrial septal defect and its impact on right ventricular function: An animal study with the pressure-volume conductance system.

Cardiology Journal — Sun, 12 Jun 2011 00:00:03 +0100

Conclusions: Device implantation is necessary to create a patent ASD resulting in significant left-to-right shunting. In an experimental ASD model, a five week period of chronic RV volume overload does not alter RV contractility significantly. (Cardiol J 2011; 18, 3: 289-296). PMID: 21660919 [PubMed - in process] (Source: Cardiology Journal)

Transpulmonary thermodilution in a pediatric patient with an intracardiac left-to-right shunt

Journal of Clinical Monitoring and Computing — Wed, 08 Jun 2011 15:48:44 +0100

We describe and explain the influence of a left-to-right shunt on TPTD curve characteristics and EVLW measurements in a young child undergoing a surgical atrial septal defect repair. We suggest that these specific changes in the TPTD curve and the overestimation of EVLW detected by current device, in absence of gas exchange abnormalities, could be indicators of existing circulatory shunts in pediatric patients. Content Type Journal ArticlePages 1-4DOI 10.1007/s10877-011-9281-5Authors Geoffray Keller, Hospices Civils de Lyon, Groupement Hospitalier Est, Department of Anesthesiology and Intensive Care, Louis Pradel Hospital and Claude Bernard Lyon 1 University, INSERM ERI 22, Lyon, FranceOlivier Desebbe, Hospices Civils de Lyon, Groupement Hospitalier Est, Department of Anesthesio...